Authorizations Supervisor

California Pain•San Diego, CA

1d•$75,000 - $80,000•Onsite

About The Position

The Authorizations Manager leads the prior authorization function across all six sites of service, ensuring every clinic procedure and surgery center case is authorized accurately, completely, and ahead of schedule. This role owns the full authorization lifecycle — from order receipt through payer submission, peer-to-peer coordination, appeal, and approval — and manages a team of authorization coordinators supporting both the clinics and the ASCs. The right candidate combines deep payer knowledge with strong team leadership, treats denials as solvable problems, and understands that in a procedural practice, the authorization pipeline is the revenue pipeline.

Requirements

Five or more years of prior authorization, utilization management, or revenue cycle experience in a specialty medical practice or ambulatory surgery center setting.
Two or more years of supervisory or management experience leading an authorizations, referrals, or revenue cycle team.
Strong working knowledge of CPT/ICD-10 coding, medical necessity criteria, and payer authorization portals (e.g., Availity, payer-specific UM platforms).
Experience with commercial, Medicare, Medi-Cal, and workers' compensation authorization requirements in California.
Proficiency with practice management systems and Microsoft Excel; ability to build and interpret operational reports.

Nice To Haves

Experience in interventional pain management, orthopedics, neurosurgery, or another procedure-heavy specialty.
Familiarity with AdvancedMD or a comparable practice management platform.
Experience with implant-based procedures and device vendor coordination (e.g., spinal cord stimulation, sacral neuromodulation).
Certification such as CPC, CRCR, or CHAM, or a bachelor's degree in healthcare administration or a related field.

Responsibilities

Manage day-to-day operations of the authorizations department, including workload distribution, queue oversight, and daily prioritization across four clinics and two surgery centers.
Hire, train, coach, and evaluate authorization coordinators; build standard work, productivity benchmarks, and quality audit processes for the team.
Own the end-to-end prior authorization process for interventional pain procedures, including epidural steroid injections, medial branch blocks, radiofrequency ablation, kyphoplasty, spinal cord stimulator trials and implants, sacroiliac joint fusion, and sacral neuromodulation.
Ensure surgery center cases are fully authorized, benefit-verified, and documentation-complete well in advance of scheduled dates; partner with ASC schedulers and vendor representatives to keep the advanced procedures pipeline moving.
Manage authorizations across a diverse payer mix, including commercial plans, Medicare and Medicare Advantage, Medi-Cal and managed Medi-Cal, workers' compensation, VA/community care referrals, and personal injury lien cases.
Track denial and peer-to-peer trends by payer and procedure; lead appeals strategy, escalate systemic issues, and work with clinical leadership to strengthen documentation that supports medical necessity.
Develop and report key metrics — turnaround time, authorization aging, denial rate, peer-to-peer conversion, and cases-at-risk — and present them to executive leadership on a regular cadence.
Maintain accurate authorization records in the practice management system; ensure clean handoffs to scheduling, front office, and billing teams.
Stay current on payer policy changes, CPT code requirements, and medical necessity criteria affecting interventional pain procedures; communicate changes to providers and staff proactively.
Support revenue cycle initiatives, payer contracting analyses, and new service line launches by providing authorization feasibility and payer requirement input.